Pneumonia is an infection of the lungs deﬁned as the presence of "new lung inﬁltrate plus clinical evidence that the inﬁltrate is of an infectious origin, which include the new onset of fever, purulent sputum, leukocytosis, and decline in oxygenation" (Kalil et al., 2016). Pneumonia can be caused by viruses, bacteria, and fungi and can cause mild to severe illness in people of all ages and (Centers for Disease Control and Prevention (CDC), 2020).
For pneumonia to occur in any setting, at least one of the following three conditions must occur:
Despite advances in the understanding of contributing causes and prevention, hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP) continue to be frequent complications of hospital care. Together, they are among the most common hospital-acquired infections (HAIs), accounting for 22 per cent of all HAIs (Kalil et al., 2016).
HAP is an acute lower respiratory tract infection that is, by definition, acquired after at least 48 hours of admission to the hospital and is not incubating at the time of admission. Among patients with hospital-acquired infections, HAP is the leading cause of death and causes 22% of all hospital-acquired infections. Though generally considered to be less severe than ventilator-associated pneumonia (VAP), even in HAP serious complications occur in approximately 50% of patients, including respiratory failure, pleural effusions, septic shock, renal failure, and empyema (Kalil et al., 2016).
Ventilator-associated pneumonia (VAP) is defined by infection of the pulmonary parenchyma in patients exposed to invasive mechanical ventilation for at least 48 hours and is part of ICU-acquired pneumonia. VAP remains one of the most common infections in patients requiring invasive mechanical ventilation.
VAP is reported to affect five to 40 per cent of patients receiving invasive mechanical ventilation for more than two days (Papazian et al., 2020). Compared to similar patients without VAP, these infections negatively impact important patient outcomes and prolong both the length of mechanical ventilation and hospitalization (Kalil et al., 2016). Kalil et al. indicate that while all-cause mortality associated with VAP has been reported to range from 20 to 50 per cent, the mortality directly related to VAP is debated (2016).
In all healthcare settings, there is significant risk of transmission of acute respiratory infection (ARI) to patients and to healthcare providers. This is due to:
To prevent hospital-acquired pneumonia in hospitalized adult patients by implementing proven interventions.